Scientific journal
European Journal of Natural History
ISSN 2073-4972

CLINICAL VALUE OF THE DEFINITION OF SPECTRUM UROPATHOLOGICAL AGENTS IN CHILDREN WITH OBSTRUCTIVE PYELONEPHRITIS AT THE PRESENT STAGE

Razin M.P., Lavrov O.V., Razin A.P., Ignat`yev S.V.
In the context of children´s urinoexcretory tract obstructive disease number growth tendency and a large percentage of complications of these diseases with secondary infectious processes, we undertook an attempt to evaluate the features of pyelonephritis microflora in children with congenital obstructive uropathy COU) in its dynamics and to clear up the reasons of various potency of inflammatory processes in different patients. Patient histories of 5-14 year-old children with COU, who had been treated in the surgical department of Kirov Regional Clinical Children´s Hospital from 1997 to 2002, and the data for urine culture obtained during the children´s examination in three months after discharge from the hospital were subject to the retrospective analysis. Obstructive pyelonephritis complicated COU in 90,4% of the cases, 52 patients being examined.

At the admission to the hospital St.aureus (42,3%) were cultured more often, more rarely - in decreasing order- epidermal staphylococcus, collibacillus, Klebsiella, saprophytic staphylococcus, streptococcus, enterobacterium, seracia. The culture was negative in 13,7% of the patients. In the dynamics the microflora had been changing and, at the discharge of the child from the hospital, E.coli (23%) were detected more often, more rarely - epidermal staphylococcus, blue pus bacillus, mycology, aurococcus, Klebsiella, Proteus, enterobacterium. The culture was negative in 34% of the patients. In three months St.epidermidis, E.coli (по 13,5%) lead, yeast-like fungi were detected in 23,5% of the cases. Blue pus bacillus, different staphylococcal associations, Proteus, Seracia and aurococcus were cultured more rarely. The urine culture had no results in 21, 3 % of the cases.

For the quantitative concept of intoxication syndrome as one of the inflammatory process potency component we calculated the leucocytic index of intoxication (LII). In the patient general group at the admission to the hospital it was high and in average it was equal to 3,42. In the dynamics normalization of the index was marked. Significant differences of the LII meanings were detected in "aseptic" diseases (0,98) and COU with pyelonephritis (3,6). More than that, we paid attention to the fact that the LII at the admission was much more higher than overall average (≈6,93) in a particular group of patients. The disease forms of these children were very different, and all of them were complicated with pyelonephritis. Having compared the data we found out that E.coli. was cultured from the urine in 75% of the cases during the first term of the research in  a group of patients with the most active pyelonephritis.

By virtue of our research results we can make the following conclusions:

  1. The status severity of sick children with COU is primarily conditioned by the activity of secondary infectious process, and the laws of representation in microbiological spectrum have stage character.
  2. The maximal evidence of the intoxication syndrome is typical of coli-mediated secondary chronic obstructive pyelonephritis.
  3. As fungi and Proteus had never been cultured at the children´s admission to the hospital, their identification should be evaluated as a complication of antibacterial therapy at the discharge from the hospital and in long-term period.
    The article is admitted to the International Scientific Conference « Current problems of science and education», Cuba, (Varadero), 2007 March 19-30; came to the editorial office on 16.02.07